Discussion of public health and health care policy, from a public health perspective. The U.S. spends more on medical services than any other country, but we get less for it. Major reasons include lack of universal access, unequal treatment, and underinvestment in public health and social welfare. We will critically examine the economics, politics and sociology of health and illness in the U.S. and the world.

Friday, December 09, 2005

Murder for Gain

Merck claimed that it did not know that Vioxx increased the risk of heart attack and stroke until a study last year, after which it withdrew the drug from the market. The company and its hired researchers, notably Dr. Alise Reicin, who has testified on behalf of the company at the Vioxx trials, claim that an earlier study published in The New England Journal of Medicine in 2000 showing an increased risk of heart attack in subjects taking Vioxx, as opposed to Aleve (naproxen), demonstrated a protective effect of Aleve, not a harmful effect of Vioxx.

It turns out, according to the editors of NEJM, that the 2000 study could only be interpreted in that way because it was fraudulent. They have posted an editorial on-line, available to non-subscribers (PDF). Specifically, the authors of this study knew of three additional heart attacks in the Vioxx groups which they did not report. This raised the relative risk for Vioxx users from 4 to 5. They also deleted information from the manuscript about strokes and other vascular problems.

The company then went on to continue to market the drug aggressively for four years.